Adaptação transcultural e análise das propriedades de medida do questionário de usabilidade em telessaúde para a população brasileira (TUQ Brazil)

Abstract

Introduction: Telehealth is the provision of health care remotely through telecommunication and information tools. Usability is the extent to which a product can be used by specific users with effectiveness, efficiency, and satisfaction in a particular usage context. Measuring the usability of health technologies can provide useful information to improve their effectiveness, making them easy to use for the user. Literature shows different methodologies and tools to assess the quality of a product or service based on users‘ opinions, among them, questionnaires are one of the most used tools. Created in 2016, the Telehealth Usability Questionnaire (TUQ) combines items from existing telehealth questionnaires and information systems usability questionnaires. The TUQ was designed to cover important usability factors in telehealth and has applicability for assessment in the Brazilian population. Objectives: To carry out the translation and cross-cultural adaptation of the TUQ into the Portuguese language spoken in Brazil and its measurement properties. Methods: The cross-cultural adaptation of the TUQ was carried out following the specific methodology for translation and adaptation of questionnaires. This methodology consists of five essential steps: (1) translation of the instrument from the source language to the target language (2) synthesis of translated versions, (3) reverse translation, (4) expert committee evaluation, and (5) evaluation of the pre-final version. Steps 1 to 4 were carried out via the internet, and step 5 was carried out in person with users of various telehealth systems. Data analysis: Content validity was evaluated through the agreement index between the members of the expert committee or the content validity index (CVI); reliability, assessed by intraclass correlation coefficient (ICC) and calculation of Spearman's correlation coefficient; internal consistency, assessed by Cronbach's Alpha; and criterion validity, of the concurrent type, tested through the correlation between the items of the TUQ Brazil and the System Usability Scale (SUS) in the Brazilian Portuguese language. Results: The TUQ was successfully translated and cross-culturally adapted. In total, sixty-four subjects participated in the study. Of these, thirty were individuals assisted by the telehealth system and twenty-four were health professionals. The most common telehealth modality with usability evaluated by the TUQ was telemonitoring. The TUQ Brazil presented an excellent CVI of 0.96, and the percentages of understanding of the items were higher than 90%. Furthermore, the resulting version of the questionnaire demonstrated great internal consistency (α = 0.94); excellent intra-examiner reliability (ICC= 0.85); no significant difference between the test-retest [T (0.425), p> 0.673] and the agreement showed no bias of proportion (p = 0.320). There was a moderate correlation between TUQ Brazil and SUS (r=0.52, p<0 0001). Conclusion: The translated and cross- culturally adapted version of the TUQ into Portuguese (TUQ Brazil) has adequate content validity and good indicators of reliability and concurrent validity of the instrument in the Brazilian population